Articles: emergency-department.
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Pediatric emergency care · Sep 2023
Nonaccidental Pediatric Trauma; Which Traditional Clues Predict Abuse?
The objective of this study is to determine which of the child abuse clues quoted in the literature predict nonaccidental trauma (NAT): history incongruent with injuries found on examination or imaging, old injuries present, history of trauma denied by caregivers, multiple fractures present, changing history, fractures of varied duration, metaphyseal fracture, ear bruise, neck bruise, different history (second historian), and metaphyseal fracture. ⋯ In this 4-year study of NAT, the clinical clue that best predicted likely abuse after expert investigation was a history that was incongruent with the injuries found on emergency department evaluation. The incidence of possible early recognition from a prior emergency department visit in this group was very low, <2% of cases.
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Emergency nurses face traumatic and stressful events of many different forms and severity. The aim of this study is to test the validity and reliability of the Traumatic and Routine Stressors Scale on Emergency Nurses in Turkey. ⋯ The Turkish version of the Traumatic and Routine Stressors Scale on Emergency Nurses, has high levels of validity and reliability. We recommend that the scale be used to evaluate the state of being affected by traumatic and routine stressors among emergency service nurses.
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Mental and behavioral health (MBH) emergencies in children and youth continue to increasingly affect not only the emergency department (ED), but the entire spectrum of emergency medical services for children, from prehospital services to the community. Inadequate community and institutional infrastructure to care for children and youth with MBH conditions makes the ED an essential part of the health care safety net for these patients. As a result, an increasing number of children and youth are referred to the ED for evaluation of a broad spectrum of MBH emergencies, from depression and suicidality to disruptive and aggressive behavior. ⋯ These factors contribute to prolonged ED stays and boarding, which negatively affects patient care and ED operations. Strategies to improve care for MBH emergencies, including systems level coordination of care, is therefore essential. The goal of this policy statement and its companion technical report is to highlight strategies, resources, and recommendations for improving emergency care delivery for pediatric MBH.
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Emergency department patient boarding is associated with hospital mortality and increased hospital length of stay. The objective of the present study is to describe the impact of deploying an Intensive Care team in the ED and its association with sepsis mortality and ICU length of stay. Patients admitted to ICU through the ED with an ICD-10 CM diagnosis of sepsis were included. ⋯ Septic shock and ED boarding time were associated with prolonged ICU LOS. Compliance with SEP-1 bundle was associated with its reduction. Implementation of an ICU team in the ED for the treatment of septic patients during high volume hospitalizations is not associated with a reduction of mortality or ICU LOS.